Pandemic flu a given, local health officials urge
preparation
There are three ingredients to pandemic influenza
– a widespread outbreak of a new flu virus to which humans have
no immunity. The first is that a new influenza subtype must emerge.
Second, it must infect humans and cause serious illness. Lastly, it
must spread easily and continuously without interruption among
humans.
A new influenza strain, H5N1, known as
”
avian
”
or
”
bird flu,
”
is being watched closely by local and international health
officials as a likely candidate for pandemic flu. The virus meets
the first two criteria.
Pandemic flu a given, local health officials urge preparation
There are three ingredients to pandemic influenza – a widespread outbreak of a new flu virus to which humans have no immunity. The first is that a new influenza subtype must emerge. Second, it must infect humans and cause serious illness. Lastly, it must spread easily and continuously without interruption among humans.
A new influenza strain, H5N1, known as “avian” or “bird flu,” is being watched closely by local and international health officials as a likely candidate for pandemic flu. The virus meets the first two criteria.
But slowing the spread of a virulent flu, when it should hit, will come down to local efforts.
“When it hits, you really have to be concerned about limiting the spread of the disease,” said Joy Alexiou, a spokesperson for the Santa Clara County Public Health Department. “So you want to put into practice all those things, some of it is common sense, like using tissues when you cough or sneeze or sick people staying home and being taken care of with proper precautions.”
The SCC Public Health Department is currently putting the finishing touches on guidelines for individuals, schools and businesses should a pandemic hit. Santa Clara County shared their guidelines for diagnosis and treatment of influenza with the San Benito County Public Health department, which posted the document to their Web site.
“We need to have individual participation, business, community and government participation to be able to at all manage and limit the spread of this,” Alexiou said. “We are really taking this seriously.”
One of the best tips, Alexiou said, is keeping an emergency kit stocked with items important for a pandemic. Items that should be added to the kit include masks, gloves, a rehydration solution and ibuprofen or Tylenol.
“[People] should have extra medication and know what a rehydration solution is and how to use it,” she said. “Doctors and nurses will be sick, too. Police and firefighters. They are not immune.”
Though scientists can only estimate the effect of the next pandemic, Santa Clara County is planning for an 18-month long breakout with 25 percent of the population falling ill.
“The impact will be universal. It will be social, economic and in the healthcare industry,” Alexiou said.
In the U.S., the Centers for Disease Prevention and Control estimates that 15 to 35 percent of the population will be affected by a pandemic. With as much as 15 percent of citizens falling ill at the same time, the economy will be hard hit. Businesses may need to limit their hours, transportation may be restricted and events may be cancelled, said Alexiou. The economic impact is expected to be $71.3 to $166.5 billion, according to the CDC.
The new virus first infected humans working closely with bird populations in 1997, according to the CDC. In 2003, the World Health Organization began tracking the outbreaks, which were isolated to Asian countries until this month when the first European cases were reported in Turkey.
The first human H5N1 infections were found in Vietnam, and others followed in Thailand, China, Cambodia and Indonesia. Most cases have been a result of direct or close contact with infected poultry such as chickens, ducks and turkeys, the CDC said. Currently, transmission from person to person is rare and has not continued beyond one person.
From 2003 to 2006, WHO confirmed 151 human cases through laboratory tests. Of those cases, 82 resulted in death. During a weeklong meeting of the United Nations health agency Lee Jong-Wook, a doctor for WHO, said the organization is not over hyping the threat posed by bird flu.
“Concern has been expressed that we are overplaying this threat. We are not,” Lee said. “We can only reduce the devastating human and economic impact of a pandemic if we all take the threat seriously now and prepare thoroughly. This is a global problem.”
The flu has ravaged poultry stocks in Asia since 2003 and has spread to parts of Europe through migratory birds.
“There is no avian flu here in the United States. As best we know there are no sick birds,” Alexiou said. “Migratory birds are carriers and could bring it to domestic birds who could pass it to people.”
She said locals don’t need to worry about catching the illness from loose chickens or birds at this time.
The California Department of Food and Agriculture has created the Avian Health Group to provide answers to chicken or pet bird owners and advice on how to monitor the health of birds.
Before the virus can become a pandemic, a reassortment or an adaptive mutation need to occur to make it more easily transmissible among humans. An adaptive mutation is a gradual process where the capability of the virus to bind to human cells increases during infections of humans.
“It won’t look like it does today because it needs to be more transmissible,” Alexiou said. “It’s people to people transmission you have to worry about.”
A reassortment occurs when genetic material is exchanged between a human and the virus. It is the fastest way the virus would change to be more transmissible.
“A pandemic could arise with little or no warning from the animal side,” Lee said.
While there is a chance that the H5N1 may never make the leap to a pandemic, history has shown that pandemic flu is a regular occurrence and it is best to be prepared for the worst, Alexiou said.
The United States suffered three pandemics in the 20th century with various results. The Spanish flu, H1N1, emerged in 1918 and caused the highest number of known influenza deaths. The flu killed many infected people within the first few days after infection, and others died of secondary complications.
As many as 50 million people died world wide, according to the CDC. In the United States 4.7 in 1,000 people died of the flu, nearly half of them young and healthy adults.
The Asian Flu, H2N2, started in China in Feb. 1957 and spread to the United States by June 1957. The last outbreak of a pandemic flu occurred in 1968, when the Hong Kong Flu, H3N2, spread from Hong Kong to the United States. In each case of pandemic flu during the last century less than 1 percent of the U. S. population died.
“Health professionals and scientists are concerned because most people think the pandemic will happen in the next few years,” Alexiou said. “The timing is right and this virus has the ability to infect humans.”
While world health establishments work to track the virus, federal and state agencies are working on developing vaccines and antiviral drugs that could be used to treat the new strain of influenza if it were to reach pandemic levels. Vaccinations will be given first to health and emergency officers so spread of the disease will remain the forefront of fighting the illness.
“There won’t be any outside help because everyone else will be facing the same situation,” Alexiou said. “We all need to be able to manage and limit the spread of this on our own.”
Resources:
Centers for Disease Prevention and Control – www.cdc.gov or 404-639-3535
Avian Health Group – www.cdfa.ca.gov/ahfss/ah/avian_health_program.htm or 800-491-1899
San Benito County Public Health – http://www.sanbenitoco.org/
Santa Clara County Public Health – www.sccgov.org/portal/site/phd/
The Associated Press contributed to this report.
